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How Rehospitalization Hurts Everyone in the Health Care System

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Published:  May 3, 2016

Rehospitalization, also referred to as readmission, is the Achilles heel for the entire U.S. health care system. The average cost for a single patient to be readmitted to a hospital is $11,200. That sum takes a massive toll on everyone involved, especially when you consider the following:

  • A 2009 New England Journal of Medicine study found that 19.6 percent of the 11,855,702 Medicare beneficiaries discharged between 2003 and 2004 were rehospitalized.
  • The problem has only worsened as providers struggle to adapt to the ever-changing landscape of the Obama administration’s health care reform.

Here’s how rehospitalization affects providers, patients, and families.

Providers: Bottom Line and Burnout

Hospitals are required to report all readmissions to the Centers for Medicare and Medicaid Services (CMS), and are not compensated for the care they provide to individuals who are readmitted. Furthermore, if a hospital exceeds their expected readmission rate for a given year, the CMS enforces additional penalties up to 3 percent of the hospital’s total Medicare reimbursement. Many hospitals suffer continual blows to their finances because they are incurring the 3 percent penalty.

Bottom line aside, rehospitalization also contributes to overcrowding, which puts increased pressure on medical personnel to work long, tiring days. In a 2011 survey by the American Nurses Association, three out of four nurses cited work-related stress and exhaustion as one of their top health concerns. In 2012, a national survey published in the Archives of Internal Medicine found that nearly half (46 percent) of U.S. physicians reported feeling burned out on the job.

Patients: Dependency on a Cyclical System

If you were to poll a random selection of hospital patients, most would tell you that they felt like they were being rushed out the door. Meanwhile, the risk of rehospitalization increases as patients are evaluated less thoroughly. 

When a patient is readmitted numerous times, they become dependent on a system that is failing them. They aren’t properly educated to manage their disease or condition, which lands them back in the hospital. It’s a vicious cycle in which many patients are readmitted numerous times. 

Families: Undue Stress

Having a loved one hospitalized is an extremely stressful experience, especially in situations where end-of-life care might be on the horizon. Families in crisis are faced with the added day-to-day stress of getting to the hospital, finding parking, possibly staying the night there and getting a poor night’s sleep, wondering if their loved one will be moved to a different facility, etc. The whole process is physically and emotionally draining, which can lead to illness, anxiety, and depression. 

The Answer: In-Home Care

The solution to rehospitalization is in-home care, whether it’s home care, home health, or hospice. Each patient has their own unique situation that will determine which is best; the challenge for providers is that few in-home care providers offer all three services. 

Mission does provide all three options, serving as the bridge of communication between hospitals and primary care providers. Together, home care, home health, and hospice effectively keep patients out of the hospital and in the comfort of their own homes, all while still providing the personalized care they need. The Mission difference is exemplified in: 

  • Educating our staff to provide the highest level of care.
  • Services and training targeted specifically toward eliminating rehospitalization.
  • Hospice as a means of living rather than an aid for dying.
  • The resources of a corporate national care provider with the personal approach of a small, local provider.
  • A 24-hour call center to field patients’ needs. 

Don’t let your practice and patients suffer from the effects of rehospitalization. To learn more about how we can help, click here.